CAJ | 학술논문

目的通过影像学研究颈椎后前向松动和牵引的同时行后前向松动产生的椎间运动,并对比分析.方法选取正常受试者12例,其中男6例,女6例；年龄18 ～ 25岁,平均年龄(22.9±4.7)岁；平均身高为(1.64±0.07)m；平均体重(54.7±7.6)kg.12例受试者均接受单纯的后前向关节松动(单纯松动术)和牵引的同时行后前向松动(牵引松动术),于每种治疗方法开始前及治疗结束后(治疗后)行X线片采集,采用四张静态颈椎侧位片,收集前椎间隙、后椎间隙、后关节突关节间隙的轴向位移及椎体前后位移,每次治疗前、后的变化率,以及运动节段矢状面的旋转和移动变化率.结果治疗后,单纯松动术在C2～C7矢状面旋转角度变化之和均显著高于牵引松动术(P＜0.05)；单纯松动术在C5节段前椎间隙以及C2～C7前椎间隙之和均显著高于牵引松动术(P＜0.05),而牵引松动术后椎间隙以及C2～C7后关节突间隙均显著高于单纯松动术(P＜0.05),单纯松动术和牵引松动术椎体的前、后位移,2组间差异无统计学意义(P＞0.05),单纯松动术C5 ～C2椎体与基线相比产生向后位移,牵引松动术C5～C2椎体与基线相比产生向后位移,而C6产生向前位移.结论单纯松动术可明显增加C3～C7脊柱的前凸,减小后椎间隙和后关节突间隙,而牵引松动术可改变其椎间运动.
목적 통과영상학연구경추후전향송동화견인적동시행후전향송동산생적추간운동,병대비분석.방법 선취정상수시자12례,기중남6례,녀6례；년령18 ～ 25세,평균년령(22.9±4.7)세；평균신고위(1.64±0.07)m；평균체중(54.7±7.6)kg.12례수시자균접수단순적후전향관절송동(단순송동술)화견인적동시행후전향송동(견인송동술),우매충치료방법개시전급치료결속후(치료후)행X선편채집,채용사장정태경추측위편,수집전추간극、후추간극、후관절돌관절간극적축향위이급추체전후위이,매차치료전、후적변화솔,이급운동절단시상면적선전화이동변화솔.결과 치료후,단순송동술재C2～C7시상면선전각도변화지화균현저고우견인송동술(P＜0.05)；단순송동술재C5절단전추간극이급C2～C7전추간극지화균현저고우견인송동술(P＜0.05),이견인송동술후추간극이급C2～C7후관절돌간극균현저고우단순송동술(P＜0.05),단순송동술화견인송동술추체적전、후위이,2조간차이무통계학의의(P＞0.05),단순송동술C5 ～C2추체여기선상비산생향후위이,견인송동술C5～C2추체여기선상비산생향후위이,이C6산생향전위이.결론 단순송동술가명현증가C3～C7척주적전철,감소후추간극화후관절돌간극,이견인송동술가개변기추간운동.
Objective To compare the cervical intervertebral movements produced by posteroanterior cervical mobilization and posteroanterior cervical mobilization combined with cervical traction by using the radiographic measurement.Methods The study recruited 12 normal volunteers (6 men,6 women),aged 18 to 25 years (22.9±4.7 years),heighted (164± 7)cm and weighed (54.7 ± 7.6)kg.All the subjects were administered with posteroanterior cervical mobilization followed by posteroanterior cervical mobilization while having cervical traction,or vice versa,with an interval of 2 days in between.The X-ray films were collected before and after the treatment,using 4 static cervical lateral views.The axial displacement of posterior and anterior intervertebral separation (IVS),and the shear displacement of vertebral body as well as the rotation and displacement rate of the motion segments in the sagittal plane before and after the treatment were measured on the radiographic images and compared.Results It was shown that the posteroanterior cervical mobilization produced greater C2-C7 rotation range of motion in the sagittal plane,as compared to that by the posteroanterior mobilization while having cervical traction (P ＜ 0.05).The posteroanterior mobilization produced a significantly greater increase of anterior IVS of the C5 segment and the summation of C2-C7 posterior IVS than those by posteroanterior mobilization while having cervical traction (P ＜ 0.05).However,the posterior IVS and the posterior zygapophysial joints separation of C2-C7 produced by the posteroanterior mobilization during traction were more prominent (P ＜ 0.05).There was no statistical difference between anteroposterior displacements of the vertebral body produced by the two interventions.Comparing with the baseline,the posteroanterior mobilization caused posterior movement of the vertebral bodies of C5 to C2,while the posteroanterior cervical mobilization during traction produced posterior movement of C5 to C2 vertebral bodies and anterior movement of C6 body.Conclusion The cervical posteroanterior mobilization significantly increased the lordosis from C3 to C7,and reduced posterior IVS and zygapophysial joints separation.However,the posteroanterior mobilization during traction changed the intervertebral movements.